The U of M guidelines for classifying Attention Deficit/Hyperactivity Disorder (ADHD) as a disability exist to aid professionals who diagnose U of M students and potential students with ADHD. The guidelines themselves are not unique since they follow the generally accepted criteria for diagnosing ADHD. What is unique is that the University is asking clinicians to provide more information concerning the student’s diagnosis.
In the past, most letters of documentation that students presented to the SSD office merely contained a statement that the student had ADHD. Given the increasing numbers of students with ADHD who are attending college and the heterogeneous nature of the disorder (no two people with ADHD have the same needs, strengths, and weaknesses), it has become too difficult for service providers to actively advocate on a student's behalf with such minimal information. By requesting more information, we hope that students will receive timely and appropriate academic accommodations needed for their success.
A student may qualify to register with SSD and receive supportive services at the U of M if the student has received a comprehensive diagnosis of ADHD as outlined in the current version of the DSM. Further stipulations are that:
- A thorough battery of age-appropriate testing shall have been completed to establish the diagnosis of ADHD.
- The diagnostic report shall include relevant testing information, including diagnostic test used, test scores obtained, and the interpretations of these scores.
- The documentation must provide evidence of current impairment.
- The evaluator must be qualified to conduct and interpret diagnostic testing.
- And the documentation shall establish a rationale that supports the need for specific accommodations.
When it is dissatisfied with the quality of the presenting documentation, SSD reserves the right to require further evaluation of a student.
Diagnostic Criteria for ADHD
The current version of the Diagnostic and Statistical Manual (DSM) states that "the essential feature of attention deficit hyperactivity disorder (ADHD) is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development." (p. 61). The DSM specifies that the following criteria must be met when diagnosing ADHD:
- Often fails to give close attention to details or makes mistakes in schoolwork, work, or other activities.
- Often has difficulty sustaining attention in tasks or play activities.
- Often does not seem to listen when spoken to directly.
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instruction).
- Often has difficulty organizing tasks and activities.
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework).
- Often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools).
- Is often easily distracted by extraneous stimuli.
- Is often forgetful in daily activities.
- Often fidgets with hands or feet or squirms in seat.
- Often leaves seat in classroom or in other situations in which remaining seated is expected.
- Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness).
- Often has difficulty playing or engaging in leisure activities quietly.
- Is often "on the go" or often acts as if "driven by a motor".
- Often talks excessively.
- Often blurts out answers before questions have been completed.
- Often has difficulty awaiting turn.
- Often interrupts or intrudes on others (e.g., butts into conversations or games).
3) Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.
- Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).
- There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.
- The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Mental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, or a Personality Disorder).
Diagnostic Code Based on Type:
314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type: If both Criteria A1 and A2 are met for the past 6 months.
314.01 Attention Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: If Criteria A1 is met but Criterion A2 is not met for the past 6 months
314.01 Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type: If Criterion A2 is met but Criterion A1 is not met for the past 6 months
Coding Note: For individuals (especially adolescents and adults) who currently have symptoms that no longer meet full criteria, "In Partial Remission" should be specified.
Diagnostic instruments shall include a combination of the following measures: a clinical interview; symptom checklists including the Wender Utah Rating Scale (WURS) and the Copeland Symptom Checklist for Adult Attention Deficit Disorders (CSAADD); intelligence tests such as the WAIS-R and the Woodcock-Johnson tests of Cognitive Ability (WJ); and tests of attention and memory such as Tests of Variables of Attention Computer Program (TOVA), the Continuous Performance Test (CPT), the Gordon Diagnostic System (GDS), the Wisconsin Card Sorting Task (WCST), Trail Making Tests (TMT), the Paced Auditory Serial Test (PASAT), the Attention Capacity Test (ACT), the Wechsler Memory Test (WMS), the California Verbal Learning Test (CVLT), and the Kagen Matching Familiar Figure Test (KMFFT).
Documentation Must Be Current
Because the provision of all reasonable accommodations and services is based upon assessment of the current impact of the disability on academic performance, it is in a student’s best interest to provide recent and appropriate documentation. In most cases, this means that a diagnostic evaluation must have been completed within the past three years. Flexibility in accepting documentation that is more than three years old may be important under certain circumstances if the previous assessment is applicable to the current setting. Reevaluation may be required if documentation is inadequate in scope or content, does not address the individual’s current level of functioning, and/or does not state the specific accommodations recommended. SSD may be able to assist in such supportive reevaluation or in making referrals.
Qualifications of the Evaluating Professional
Professionals conducting assessments, rendering diagnoses, and making recommendations to accommodate students with ADHD must have comprehensive training and relevant experience in differential diagnosis of ADHD and direct experience with an adolescent or adult ADHD population. Qualified professionals may include: psychologists, neuropsychologists, psychiatrists, and other relevantly trained medical doctors. The name, title, and professional credentials of the evaluator must be clearly stated in the documentation. Information about license or certification as well as the area of specialization, employment, and state or province in which the individual practices is also needed. All reports shall be on letterhead, typed, dated, signed, and otherwise legible.
A Further Note
Because of the challenge of distinguishing normal behaviors and developmental patterns of adolescents and adults (e.g., procrastination, disorganization, distractibility, restlessness, boredom, academic underachievement or failure, low self-esteem, chronic tardiness or lack of class attendance) from clinically significant impairment, a multifaceted evaluation should also address the intensity and frequency of the symptoms and whether these behaviors substantially limit one or more major life activity. Given that many individuals benefit from prescribed medications and therapies, a positive response to medication by itself does not confirm a diagnosis, nor does the use of medication in and of itself either support or negate the need for accommodation(s).
If the requested accommodations are not clearly identified in the diagnostic report, SSD may ask a student to seek clarification or may request further evaluation.
To Register with SSD
You will need your testing/report that was generated regarding your impairment/diagnosis; ideally we would like a Psychoeducational and/or a Neuropsychological Test that was completed within the last 5 years (using adult testing measures only).
If you do not have a psychological evaluation, your treatment provider will need to fill out our Disability Verification Form.